ABSTRACT

Objectives

To investigate the effect of motivation on improvements in the Functional Independence Measure (FIM) scores in subacute stroke patients with cognitive impairment.

Methods

This retrospective cohort study included 358 consecutive subacute stroke patients with first-ever stroke and Mini-Mental State Examination score ≤23 at admission. We determined motivation and rehabilitation outcome using the vitality index and FIM-motor gain, respectively. Stepwise multiple regression analysis was performed to identify the factors at admission related to FIM-motor gain.

Results

Of 80 participants enrolled in this study (mean age: 74.2 ± 11.3 years). The median (interquartile range) vitality index at admission and FIM-motor gain were 7 (4) and 23 (22) points, respectively. Stepwise multiple regression analysis revealed that age (B, −0.43; 95% confidence interval [CI], −0.65–(−0.21); β, −0.31; P <.001), duration from stroke onset to admission (B, −0.18; 95% CI, −0.33–(−0.04); β, −0.20; P =.014) and Stroke Impairment Assessment Set-motor function (B, 1.27; 95% CI, 0.92–1.61; β, 0.78; P <.001), FIM-motor (B, −0.80; 95% CI, −1.01–(−0.60); β, −0.95; P <.001), and vitality index (B, 3.79; 95% CI, 2.37–5.21; β, 0.50; P <.001) scores at admission were significantly associated with the FIM-motor gain.

Discussion

The vitality index was significantly associated with FIM improvement in subacute stroke patients with cognitive impairment.

中文翻译：

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活力指数是亚急性脑卒中伴认知障碍患者功能独立性测量评分改善的预测指标

摘要

目标

研究动机对认知障碍亚急性卒中患者功能独立性测量 (FIM) 评分改善的影响。

方法

这项回顾性队列研究包括 358 名连续亚急性卒中患者，这些患者在入院时的简易精神状态检查评分≤23。我们分别使用活力指数和 FIM 运动增益来确定动机和康复结果。进行逐步多元回归分析以确定入院时与 FIM 运动增益相关的因素。

结果

参加本研究的 80 名参与者（平均年龄：74.2 ± 11.3 岁）。入院时的中位（四分位距）活力指数和 FIM 运动增益分别为 7 (4) 和 23 (22) 分。逐步多元回归分析显示年龄 (B, -0.43; 95% 置信区间 [CI], -0.65 - (- 0.21); β, -0.31; P < .001)、从卒中发病到入院的持续时间 (B, - 0.18；95% CI，-0.33 - (- 0.04)；β，-0.20；P = .014）和中风损伤评估集合运动功能（B，1.27；95% CI，0.92–1.61；β，0.78；P <.001)、FIM-运动 (B, -0.80; 95% CI, -1.01 - (- 0.60); β, -0.95; P <.001) 和活力指数 (B, 3.79; 95% CI, 2.37 -5.21；β，0.50；P <.001) 入院时的分数与 FIM 运动增益显着相关。

讨论

活力指数与伴有认知障碍的亚急性脑卒中患者的 FIM 改善显着相关。